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Policy analysis paper

Not just doing affordability . Doing access to care, quality of care, health outcomes, equity, high costs, lack of universal coverage, fragmentation of the system

Take out part about duplicate parts

Take out stuff that is irrelevant

Alternatives already? Am I talking about access to health care?

Good policy should be relevant, coherent, effective, efficient, impactful, and sustainable, according to the OECD. Impact categories can be broadly classified into economic, social, environmental, and institutional impacts, with the specific categories and indicators tailored to the policy's goals.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes -

Defining Health Outcomes (might just focus on outcomes)

* Health outcomes refer to the effects of a healthcare service or intervention, encompassing various aspects like patient health status, quality of life, and population health.  

* Examples include:

* Mortality rates: A measure of the number of deaths in a population.  

* Patient safety: The extent to which patients are free from harm during care.  

* Readmission rates: The likelihood of patients returning to the hospital after discharge.  

* Patient experience: The patient's perception and satisfaction with their care.  

* Effectiveness of care: How well interventions achieve their intended goals.  

* Timeliness of care: The speed and efficiency with which care is provided.  

* Efficient use of resources: Optimizing the utilization of healthcare resources.  

* Data transparency: Making information about healthcare outcomes available to the public.  

* Equitable access to care: Ensuring that everyone has the opportunity to receive needed healthcare services.  

* Reduced healthcare disparities: Addressing differences in health outcomes among various populations.  

* Improved quality of life: Enhancing overall well-being and functioning.  

2. Role of Health Outcomes in Policy Analysis:

* Evaluation of Policy Effectiveness:  Policy analysis uses health outcomes to assess the effectiveness of interventions, such as new regulations, funding mechanisms, or public health campaigns.  

* Identifying Areas for Improvement:  By comparing actual outcomes with intended goals, policymakers can pinpoint areas where policies are falling short and identify strategies for improvement.  

* Guiding Resource Allocation:  Understanding the impact of different policies on health outcomes can help policymakers allocate resources effectively, prioritizing interventions with the greatest potential to improve public health.  

* Promoting Evidence-Based Policymaking:  Health outcomes data provides evidence for informed decision-making, ensuring that policies are based on the best available research and data.  

* Facilitating Comparative Policy Analysis:  Comparing health outcomes across different jurisdictions or over time can help policymakers identify effective strategies and practices that can be adapted to their own contexts.  

* Supporting Implementation and Evaluation:  Health outcomes are used to monitor the implementation of policies and to evaluate their impact on the target population.

Might not focus on these:

economic impacts -

Economic issues in healthcare include rising costs, limited access due to affordability, and the impact of inflation on both providers and patients. Additionally, issues like labor shortages, supply chain disruptions, and reimbursement challenges further complicate the economic landscape of the healthcare industry.

Elaboration:

* Rising Costs:  Healthcare spending continues to increase, outpacing inflation and economic growth. This includes higher drug prices, medical procedures, and hospital stays.  

* Affordability and Access:  Many individuals struggle to afford healthcare, leading to delayed or forgone care. This impacts both individuals and the healthcare system, as undiagnosed or untreated conditions can escalate into more expensive and complex problems.  

* Inflation:  Inflation affects the entire healthcare ecosystem, from the cost of medications and supplies to wages and salaries of healthcare workers. Hospitals and health systems face pressure to manage expenses while providing quality care.  

* Labor Shortages:  A shortage of healthcare workers, including nurses and doctors, adds to the financial strain on healthcare providers. Higher wages and increased competition for scarce resources further exacerbate this problem.  

* Supply Chain Disruptions:  Disruptions to the supply chain, such as shortages of medications or medical equipment, can lead to delays in care and increased costs.  

* Reimbursement Challenges:  Hospitals and health systems often receive inadequate reimbursement for complex and costly services, leading to financial strain and potential compromises in care. This is further complicated by administrative burden and denials from insurance companies.  

* Social Determinants of Health:  Factors like poverty, lack of access to healthy food, and inadequate housing can also impact health outcomes and contribute to higher healthcare costs.  

* Competition:  Competition from alternative care providers, such as telemedicine and urgent care centers, can also create economic challenges for traditional healthcare providers.  

* Regulation and Legislation:  Regulations and legislation can have both positive and negative economic impacts on the healthcare industry, influencing costs, access, and quality of care.

research and policy influence,

and environmental impacts?

Introduction

How do I include criteria for good policy like:

Efficiency

Effectiveness

Equity

Compliance?

All of these areas could involve health outcomes?

Just like every other person in the United States, health care is an issue, if not a problem, that everyone has to address in some way; even if it is just primary care. The US often ranks near the bottom among developed nations in terms of overall healthcare system performance. Despite having the highest healthcare spending per capita, spending reaching upwards of $4.5 trillion (13,493 per person), the US lags behind other high-income countries in various key areas like access, quality of care, equity, and health outcomes.

Here's a more detailed look at the US's healthcare ranking:

1. Overall Ranking:

* The US has consistently ranked last among 10 other high-income countries in terms of overall health system performance, as determined by the Commonwealth Fund. Health Care by Country 2024 Report | Commonwealth Fund

* This ranking considers factors like access to care, quality of care, equity, and health outcomes.

* Status quo

2. Key Areas Where the US Lags:

* Access to Care:

The US struggles with providing equitable and accessible healthcare for all, particularly due to high costs and the absence of universal coverage.

* Quality of Care:

While some aspects of US healthcare are highly advanced, the country performs poorly in terms of preventing deaths, managing chronic diseases, and ensuring patient safety.

* Health Outcomes:

The US has lower life expectancy and higher rates of preventable and treatable deaths compared to other high-income countries.

* Equity:

Disparities in healthcare access and outcomes exist based on race, ethnicity, income, and geographic location.

3. Factors Contributing to Poor Rankings:

* High Costs:

The US has the highest healthcare costs per capita in the world, but this doesn't translate to better health outcomes.

* Lack of Universal Coverage:

A significant portion of the population lacks comprehensive health insurance coverage, leading to financial barriers to accessing care.

* Fragmentation of the System:

The US healthcare system is complex and fragmented, with a patchwork of public and private programs, which can make it difficult to navigate and coordinate care.

4. Areas Where the US Performs Well:

* Medical Innovation:

The US is a global leader in medical innovation and research, with many advancements originating in the country.

* Access to Specialized Care:

The US has a vast network of highly specialized hospitals and medical facilities.

In conclusion, while the US has strengths in certain areas, its healthcare system overall performs poorly compared to other high-income nations, particularly in terms of access, quality, and health outcomes. The high cost and lack of universal coverage are major contributing factors to these poor rankings.

Key Aspects of the Status Quo:

* High Costs:

Healthcare spending is significantly higher than in other developed countries, yet outcomes don't always reflect this investment.

* Limited Access:

Millions remain uninsured or underinsured, hindering access to necessary care, particularly for marginalized groups.

* Quality Concerns:

While some aspects of care are excellent, there are concerns about the quality of care across the board, particularly for specific populations.

* Relying on Technology:

The U.S. healthcare system heavily relies on technology to address issues like cost and quality, but these advancements often don't translate to improved outcomes or cost savings.

* Fragmentation of Care:

The system is characterized by a lack of integration between different parts, leading to coordination issues and potentially impacting patient outcomes.

* Status Quo Bias:

There's a tendency to resist change and maintain the current practices, even when evidence suggests a need for improvement.

* Focus on Treatment, not Prevention:

A significant portion of healthcare spending is directed towards treating existing conditions, with less emphasis on prevention and early intervention.

In summary, the status quo in U.S. healthcare presents a complex picture where high costs and technological advancements are not translating into improved health outcomes and widespread access for all citizens.

Top 5 Things Washington Can Do in 2022 to Improve Health Care Affordability - ACHP

1. Protect Medicare Advantage consumer benefits

The Medicare Advantage program is in the spotlight – for good reason. CBO projects that a majority of eligible seniors will be enrolled in MA by 2023 and will reach 60% in next decade. Considering its popularity among a diverse group of seniors, now is the time to take it to the next level.

23. Allow health plans to account for audio-only encounters in risk adjustment during the pandemic to ensure patient acuity is accurately and appropriately documented and the needs of these patients continue to be met.

24. Raise the bar on quality to include more accurate health outcome metrics that help better meet the needs of seniors choosing MA.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

2. Commit to telehealth, making permanent telehealth flexibilities afforded under the PHE

Americans safely and conveniently accessed telehealth in record numbers in 2020 and 2021, clearly indicating that this method of care delivery is here to stay.

25. Congress can move Cures 2.0 and make permanent current telehealth flexibilities – specifically removing geographic restrictions – and prioritize a consistent telehealth experience across all federal programs.

26. The Administration can incent value-based benefit design that supports telehealth.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

3. Stabilize coverage including in non-Medicaid expansion states

Washington must ensure that every American maintains access to affordable coverage and care, particularly post-public health emergency.

27. Congress must make permanent the increased subsidies available to supplement coverage costs on the individual market.

28. The Administration must streamline the cumbersome Medicaid redetermination process and expand independent navigators and other enrollment assistance.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

4. Make meaningful and targeted investments in underserved communities

With a significant focus on health equity, Washington can make a difference by removing obstacles to equitable care.

29. Congress must advance the maternal health provisions included in the Build Back Better Act as well as bipartisan mental and behavioral health initiatives targeting improved access and care.

30. Incenting and standardizing health data collection across federal programs will help us understand and analyze care gaps as well as inform targeted interventions to improve health equity.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

5. Find common ground to lower the cost of prescription drugs

In the short-term, it’s critical that Congress pass and oversee implementation of the Build Back Better Act provisions targeting drug pricing.

31. Congress and the Administration can move forward on bipartisan ideas that encourage innovation, improve transparency, stem anti-competitive practices and reform the broken drug patent system.

32. Both removing obstacles to generics reaching the market and allowing formulary flexibility will improve affordability of out-of-control prescription drug prices.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

Conclusion

It might be applicable to have a system where everyone receives adequate health care insurance; even if that involves multiple ways of getting the care that they need. I am basically coming back to the same conclusion that a mixed economic system, in the health care industry, is still better than just relying on command economies and wholly market-based economies.

A policy analysis paper requires a structured approach, beginning with defining the policy problem, researching evidence, identifying policy alternatives, and evaluating them against specific criteria. Finally, a clear recommendation, supported by evidence, should be presented to the intended audience.

Here's a step-by-step guide:

1. 1. Define the Problem:  Clearly articulate the policy issue, its significance, and the need for change.   Key Aspects of the Status Quo:

* High Costs:

Healthcare spending is significantly higher than in other developed countries, yet outcomes don't always reflect this investment.

* Limited Access:

Millions remain uninsured or underinsured, hindering access to necessary care, particularly for marginalized groups.

* Quality Concerns:

While some aspects of care are excellent, there are concerns about the quality of care across the board, particularly for specific populations.

* Relying on Technology:

The U.S. healthcare system heavily relies on technology to address issues like cost and quality, but these advancements often don't translate to improved outcomes or cost savings.

* Fragmentation of Care:

The system is characterized by a lack of integration between different parts, leading to coordination issues and potentially impacting patient outcomes.

* Status Quo Bias:

There's a tendency to resist change and maintain the current practices, even when evidence suggests a need for improvement.

* Focus on Treatment, not Prevention:

1. A significant portion of healthcare spending is directed towards treating existing conditions, with less emphasis on prevention and early intervention. In summary, the status quo in U.S. healthcare presents a complex picture where high costs and technological advancements are not translating into improved health outcomes and widespread access for all citizens.

3. 2. Research and Evidence:  Gather relevant data, statistics, and credible sources to support your analysis.    

4. 3. Identify Alternatives:  Explore various potential policy solutions or options to address the problem.    

5. 4. Establish Criteria:  Develop a set of evaluation criteria (e.g., cost-effectiveness, equity, feasibility) to assess the alternatives.   Consider criteria for good policy

7. Efficiency

8. Effectiveness

9. Equity

10. Compliance

11.  

12. 5. Evaluate Alternatives:  Analyze each policy option against the established criteria, considering potential outcomes, impacts, and trade-offs.    

13. 6. Make a Recommendation:  Clearly state your preferred policy solution and provide a justification based on the analysis.   Top 5 Things Washington Can Do in 2022 to Improve Health Care Affordability - ACHP

1. Protect Medicare Advantage consumer benefits

24. Raise the bar on quality to include more accurate health outcome metrics that help better meet the needs of seniors choosing MA.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

2. Commit to telehealth, making permanent telehealth flexibilities afforded under the PHE

Americans safely and conveniently accessed telehealth in record numbers in 2020 and 2021, clearly indicating that this method of care delivery is here to stay.

26. The Administration can incent value-based benefit design that supports telehealth.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

3. Stabilize coverage including in non-Medicaid expansion states

Washington must ensure that every American maintains access to affordable coverage and care, particularly post-public health emergency.

27. Congress must make permanent the increased subsidies available to supplement coverage costs on the individual market.

28. The Administration must streamline the cumbersome Medicaid redetermination process and expand independent navigators and other enrollment assistance.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

4. Make meaningful and targeted investments in underserved communities

With a significant focus on health equity, Washington can make a difference by removing obstacles to equitable care.

29. Congress must advance the maternal health provisions included in the Build Back Better Act as well as bipartisan mental and behavioral health initiatives targeting improved access and care.

30. Incenting and standardizing health data collection across federal programs will help us understand and analyze care gaps as well as inform targeted interventions to improve health equity.

Consider criteria for good policy

Efficiency

Effectiveness

Equity

Compliance

Consider Impact categories

These categories can be categorized as: health outcomes,

economic impacts,

research and policy influence,

and environmental impacts.

5. Find common ground to lower the cost of prescription drugs

In the short-term, it’s critical that Congress pass and oversee implementation of the Build Back Better Act provisions targeting drug pricing.

31. Congress and the Administration can move forward on bipartisan ideas that encourage innovation, improve transparency, stem anti-competitive practices and reform the broken drug patent system.

32. Both removing obstacles to generics reaching the market and allowing formulary flexibility will improve affordability of out-of-control prescription drug prices.

33.

34. Consider criteria for good policy

35.

36. Efficiency

37. Effectiveness

38. Equity

39. Compliance

40.

41. Consider Impact categories

42.

43. These categories can be categorized as: health outcomes,

44. economic impacts,

45. research and policy influence,

46. and environmental impacts.  

47. Consider Audience:  Tailor your writing style and language to effectively communicate your analysis to the intended audience.   Structure and Outline:  Organize your paper logically, using sections for introduction, problem definition, background, analysis, recommendations, and conclusion.   Write Clearly:  Use plain language, avoid jargon, and present your findings in a concise and understandable manner.

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realyoungdarius · 2 months ago

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price caps on health insurance...

Price caps on health insurance, also known as rate controls, are regulations that set the maximum prices providers can charge for services. These caps can be comprehensive, affecting both in-network and out-of-network care, or focus on specific areas like out-of-network prices. The goal is to manage healthcare costs and potentially reduce price increases.

Here's a more detailed look:

Types of Price Caps:

Comprehensive Price Caps: Set maximum prices for all services, both in-network and out-of-network.

Out-of-Network Price Caps: Focus on limiting prices for care received outside of the insurance network.

Potential Impacts:

Cost Savings:Price caps aim to lower overall healthcare spending by limiting what providers can charge.

Negotiating Power:Insurers gain more leverage in negotiations with providers, potentially leading to better deals.

Access Concerns:Some argue that out-of-network caps could make it harder for patients to access certain providers, as they might choose not to accept out-of-network patients to maintain their bargaining power.

Enforcement Challenges:Enforcing comprehensive price caps can be complex, requiring robust regulatory bodies and processes.

Examples:

Some states have implemented rate review agencies that can approve or disapprove rate increases proposed by insurers.

Oregon has used price caps on hospital services for state employees.

Federal law limits how much profits insurance companies can make from premiums, encouraging insurers to control costs.

Considerations:

Balance between control and market forces :Price caps aim to address market failures while still allowing a role for market forces in determining prices.

Flexibility and adaptability: Price cap systems can be adjusted based on evidence and policy preferences.

Impact on different providers: The impact of price caps can vary depending on whether they are comprehensive or focused on specific areas, and how they are implemented.

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realyoungdarius · 2 months ago

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I have never been a pedophile! I’m not interested in being one! I may have a boyish charm but it’s be disgusting if I were into kids! I’m not even into people who don’t remember 9-11! Is this issue the reason I keep getting different looks when I want to find a way 2 help them? I don’t want to have Schizophrenic symptoms, either…

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realyoungdarius · 2 months ago

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question set #9 for pols 648

For April 16 please answer the following questions:

Answer Chapter 13 Question #1 25 Points

Answer Chapter 13 Question #2 25 Points

Also, every week please note any questions/comments you have about the readings on the discussion board and we will discuss them there and/or in class.

Your city’s highway department currently operates sidewalk snowplows. During major snowstorms, the department gives top priority to clearing major streets. Consequently, sidewalks are often not plowed until several days after major storms. What factors should the mayor consider in deciding whether to contract out for sidewalk snowplowing?

Should consider utilitarian based ethics? Why?

a. When you consider utilitarian ethics, for instance, you are trying to do great things for as many people as possible. This means that you might even mitigate things to help for things to be better for more people. This means that we most consider consequentialism and focus on maximizing overall happiness and minimizing suffering.

2. You are the mayor of a medium-sized city in a developing country. A company is seeking a contract that would give it rights of way for installing cables to provide television and modem services within the city limits. The contract would specify subscription rates for the first three years of the contract. Should you be concerned about opportunism?

a. Yes. Opportunism is the taking of opportunities as and when they arise, regardless of planning or principle. Consider first movers and secondary movers in the marketplace? Once a business loses its edge in the marketplace, which involves barriers to entry, then other companies can provide substitutes in the marketplace that are better. Also, consider that the hype of a new product on the marketplace could cause prices to rise until later on down the road after the launch of the product. This could be considered to be rent in economics, when an amount of money earned is exceeds what is economically and socially necessary? This rationale, at least, exists in metaphysics (which is an umbrella term which includes Phenomology?) if nothing else?

Opportunism arising from information asymmetry can occur either at the contract negotiation stage or after the contract has been signed (the post-contract stage), but is most likely to be significant after contract signing. Either governments or contractees may generate these costs. Higher task complexity also increases the potential for production externalities; that is, the potential for serious disruption to the rest of the public organization if the contracted service is withdrawn or degraded.24

One study finds that governments engage in more monitoring, and bear more monitoring costs, when the risks of opportunism are greater.17 Additionally, not all forms of contracting out can be expected to lower production costs. In particular, cost-plus contracts, which guarantee the contractee a profit no matter how high the measured costs of production, are unlikely to lead to lower-cost production.18 Second, cost comparison studies should control for quality differences; a few studies have done so,19 but most have not.

The degree to which the activity being contracted for is contestable affects opportunism costs. If the market for the activity is contestable, then opportunism is reduced at the contract stage and potentially also at the execution stage.

Sources:

question set #9 for pols 648

For April 16 please answer the following questions:

Answer Chapter 13 Question #1 25 Points

Answer Chapter 13 Question #2 25 Points

Also, every week please note any questions/comments you have about the readings on the discussion board and we will discuss them there and/or in class.

Should consider utilitarian based ethics? Why?

Sources:

19 For example, see Randall G. Holcombe, “Privatization of Municipal Wastewater Treatment,” Public Budgeting and Finance 11(3) 1991, 28–42; and Russell L. Williams, “Economic Theory and Contracting Out for Residential Waste Collection,” Public Productivity & Management Review 21(3) 1998, 259–71.

24 Steven Globerman, “A Policy Analysis of Foreign Ownership Restrictions in Telecommunications,” Telecommunications Policy 19(1) 1995, 21–28.

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realyoungdarius · 2 months ago

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bargaining costs, production costs, and opportunistic costs. economic profit and accounting profits...

Bargaining costs refer to the expenses incurred in reaching an agreement, while production costs are the expenses associated with creating goods or services. Opportunistic costs, on the other hand, relate to the potential gains forfeited by choosing one option over another.

Elaboration:

1. Bargaining Costs:

These are the costs associated with the negotiation process, including time, effort, and resources spent in reaching a mutually acceptable agreement.

Examples of bargaining costs can include negotiation expenses, legal fees for contract review, and costs associated with resolving disputes.

Bargaining costs can be significant in complex negotiations, such as those involving multiple parties or large transactions.

2. Production Costs:

These are the expenses incurred in the process of producing goods or services.

Examples of production costs include raw materials, labor, manufacturing expenses, and overhead costs.

Production costs are a key factor in determining the profitability of a business.

3. Opportunistic Costs (Opportunity Cost):

This refers to the potential benefits that are missed when choosing one option over another.

It is the value of the next best alternative that is foregone when a decision is made.

Examples of opportunity costs can include the lost profits from not investing in a particular project, the missed income from not accepting a different job offer, or the potential savings from not purchasing a different product.

Understanding opportunity costs helps businesses make better decisions by considering the potential gains that could be achieved through alternative choices.

4. Relationship between Bargaining Costs and Production Costs:

Bargaining costs can indirectly affect production costs. For example, if a contract is negotiated poorly, it might lead to higher material costs or reduced flexibility in production, ultimately increasing production costs.

Similarly, successful bargaining can lead to lower production costs by securing favorable terms with suppliers or reducing labor costs through collective bargaining agreements.

5. Opportunistic Costs and Bargaining:

Opportunistic behavior can increase bargaining costs. If one party suspects the other might act opportunistically, they may incur additional costs to protect themselves, such as through more detailed contracts, closer monitoring, or by engaging in more extensive due diligence.

In contrast, strong trust and cooperative behavior between parties can reduce bargaining costs by fostering a more efficient and collaborative negotiation process.

Accounting profit focuses on actual, measurable financial gains, subtracting explicit costs like wages and rent from total revenue. Economic profit, on the other hand, takes a broader view, considering both explicit and implicit costs, including opportunity costs, to assess the true profitability of a business. Essentially, accounting profit is a more limited view of profitability, while economic profit provides a more comprehensive picture by factoring in the value of forgone opportunities.

Here's a more detailed breakdown:

Accounting Profit:

Definition:Accounting profit is calculated as total revenue minus all explicit costs (actual cash outflows) incurred by a business, such as wages, rent, materials, and depreciation.

Focus:It's a financial measure of a company's performance, reflecting the bottom line after accounting for all measurable expenses.

Uses:Accounting profit is used in financial statements, tax declarations, and for comparing a company's performance with other companies or its own historical performance.

Economic Profit:

Definition:Economic profit is calculated by subtracting all costs (explicit and implicit) from total revenue. Implicit costs include opportunity costs, which are the potential benefits foregone by choosing one option over another.

Focus:It provides a more comprehensive assessment of a company's profitability, including the opportunity costs of using resources in a particular way rather than in an alternative way.

Uses:Economic profit is often used by managers to make investment decisions and evaluate the overall efficiency of the business, especially when comparing different investment opportunities.

In essence:

Accounting profit is a narrower view of profitability, focusing on what a company actually spends money on.

Economic profit is a broader view, considering the true cost of using resources, including the value of what could have been produced if those resources were used differently.

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